Clinical Epidemiology Of Pituitary Adenoma In A Tertiary Hospital In Ghana

Objective: To determine the demographic and clinical profile of patients with pituitary adenoma in a tertiary hospital in Ghana. Methodology: This retrospective study was conducted at the Endocrinology Unit, Korle Bu Teaching Hospital. The case files of all pituitary adenoma (PA) patients with complete baseline hormonal and radiological assessment were reviewed and the relevant demographic and clinical data documented. Data was analyzed using SPSS version 25. Common clinical characteristics and sex and subtype differences in the clinical profile were evaluated. Level of significance was a p-value of <0.05. Results: The analysis of the data of 244 patients revealed a female preponderance (145,59.4%) and a mean age of 42.2±13.3 years. The predominant subtypes were nonfunctioning PA (103,42.2%) and prolactinoma (103,42.2%). The most prevalent subtype in males (50, 50.5%) was nonfunctioning PA whiles that for females (78,53.8%) was prolactinoma. Headaches (163,66.8%) and visual impairment (151,61.9%) were the most common presenting symptoms although females with prolactinoma frequently had galactorrhoea (62,79.5%) and menstrual irregularities (50,64.1%). Growth hormone- and adrenocorticotropin-secreting adenomas had the longest (7.42+4.9years) and shortest (0.55+0.6years) mean duration of symptoms respectively (p<0.0001). Most (198,81.1%) PA were macroadenomas with majority (161,81.3%) compressing surrounding structures on radiological imaging. Compared with females, males commonly presented with macroadenomas (95.0% vs 71.7%), hypopituitarism (67.7% vs 45.5%), and visual field defects (87.2% vs 55.7%) (p<0.001). Conclusion: The clinical characteristics of PA in this study are suggestive of delays in diagnosis, highlighting the need to increase awareness to promote earlier diagnosis and improve patient outcomes in our setting.